As Long As No One Is Reading This...

I might was well embrace the madness and go completely off the rails.

You want to know the greatest problem with my diabetes? Me. ME! As vague as the warnings were, I didn't listen. "You could go blind." "You could lose both of your feet." Those were the two I heard the most. They would have had more impact if they'd included HOW those two things would happen, but they should have had SOME kind of impact.

Yeah, my home-life was crap. (Yeah, I'm abandoning my PG-13 stance for the moment.) A lot of people's home-lives were crap. That the incubator was especially psychologically abusive was probably the worst of it. And you wanna know what makes that worse? It was recognized very early on that I was having emotional difficulties, and school officials urged my parents to seek psychological help.

They did. And the incubator screwed that up BIG TIME! You see, the first psychologist ran a bunch of tests, and then sat my parents down to discuss the diagnosis. Said diagnosis was that I, at the tender age of eight years old, saw the incubator as a constant threat to my well-being, always looming over me, waiting to strike. Well, the incubator became highly offended by this. She was the perfect parent, and if you didn't believe that, you could just ask her and she'd tell you.

Off we went to a second psychologist. That one also ran a bunch of tests, and then sat my parents down to discuss the diagnosis. Said diagnosis was that I, at the tender age of eight years old, saw the incubator as a constant threat to my well-being, always looming over me, waiting to strike. Did she take the hint? Hell no! Did my father take the hint? If he did, he didn't want to deal with the fact that his wife was the problem, and so...

Off we went to a THIRD psychologist. This time things went differently. The incubator complained in advance about the two identical diagnoses that she thoroughly disagreed with, So Dr. Greedy came back with a diagnosis that said she was perfect, and that the problem was all in my head. "Come back weekly and we'll get him all sorted out."

Yeah, the bitch shopped for a diagnosis she preferred and ran with that instead of making any kind of effort to fix was was actually broken.

I was off to a miserable start, what with me only being a year into my life as a diabetic. And it seemed like her mission in life was to make EVERYONE miserable.

The best example of how bad things were at that place where we lived, (which was far from a "home"), was when we went to family therapy during my mid-teens. Shockingly, it was with Dr. Greedy, who by this point I knew to be a dumbass with a PhD. I complained about the incubator. My middle brother complained about the incubator. My youngest brother complained about the incubator. My father complained about the incubator. So what did the incubator do? She became angrier, more contentious, more bitter, more combative. She did no self-reflection whatsoever. We were "ganging up on her," and that made US the villains of the story.

Other kids during their rebellious years... They started doing drugs. Others would start drinking. My grand attempt at teen rebellion was to down a pound of Twizzlers while reading a Stephen King novel. And because an insulin dose at each meal was still decades away, I'd get sick. Every two or three weeks, I'd wind up in the emergency room. I lost count after 50 hospitalizations.

Remember me saying how depression comes with chronic illness? Life with the incubator only made that worse. The way I describe it is thus: "The valve that releases the negative neurochemicals that cause depression were jammed open by that abusive cow, to the point where only medication will help control it now." I also mentioned in a roundabout way that I'd recently fallen off my antidepressants. I've started the process of getting back on them, but...

Understanding my disabilities isn't easy. It wasn't understood for quite some time. Because at the time I was declared disabled, I didn't LOOK like I had health issues. You can't see severe recurrent depression. You can't see PTSD. You can't see the complications of diabetes until a foot comes off or the afflicted individual is using blind mobility cane or has a seeing-eye dog. I'd say 95% of the family members I was talking to at the time all started telling me that I wasn't sick. That I was lazy. That I just had to snap out of it. And when I did unacceptable things at the height of my mental illnesses' effects on me, they vilified me and cut me off.

My youngest brother grew up to be a fill-blown racist and misogynist. Oh, the stories I could tell about him! He's a selfish prick who only views people through the lens of, "What can they do for me." So when my father got remarried at age 69, my brother's response was, "Now there's ANOTHER person to divide the inheritance!" Translation: He was waiting for my father to die so he could get the life insurance money. Well, Dad fixed that right away, removing my brother from his will and disowning him.

My middle brother grew up to be a clone of the incubator. When his one and only child was diagnosed as clearly being on the Autism Spectrum... Okay, when my brother was telling me this, his son was in the room. When he got to his thoughts on the matter, he looked at his son and raised his voice to say, "He's just being lazy!" My brother has vanished completely. I have no idea if he's dead or alive. We have a few mutual friends, and just like me, they haven't heard from him in over five years.

I went on quite the tangent there, didn't I? I was saying that I fell of my meds and am in the process of getting back on them, but it wouldn't make much of a difference. I always get depressed around the holidays. Part of that is the fact that Dad used to send me a gift twice a year. Once on my birthday and once during the holidays. It was always $25. In his final years, he couldn't really afford it, and I wasn't in desperate need, so I'd thank him, and then would quietly tear up the check. Thing is, now I AM in need, and Dad's been dead for many years.

So I debased myself. I actually went on Facebook as asked my friends for gifts. Specifically ONE gift. I asked each of my friends to spend $10 on a PlayStation gift card. Not a lot of money. I keep thinking of $10 as being the most anyone would ask for during the office's Secret Santa. If just 20 friends did this, I'd have more than enough to buy those games I keep putting on my Wishlist. What's more, they just have to send me the code through a private message or email. No postage necessary. And knowing they did this little thing for me would help boost my battered and bruised ego.

The problem is that I have to ask. No one gets me gifts because they thought of me while shopping. I have to remind them that I exist and that a small gift would make me feel better about myself. Will I return the favor? If I could, I would. I mean, if I... Hang on...

If I won a stupid amount of money in the lottery, every single one of my friends would receive that maximum amount of money permitted without requiring them to report it to the IRS. For 2023, that amount is $17,000. Annually. Just a little leg up to do with as they pleased. What's more, they wouldn't have to ask. I'd ask for addresses, and then checks would be mailed out ASAP. Their kids would always get gifts from "Crazy Uncle Rob" during birthdays and the holidays.

I have to ask for presents. Small presents. And when I last did this, during my birthday over the summer, three people gave me gifts. Three.

Y'know, it's almost like I'm just too much to handle. Why? Because I'm so broken, physically and mentally. For the latter, I'm going to fall of my meds every now and again because it's the nature of the beast. But the former...? I did catastrophic damage to myself and I KNEW it... I just didn't care. Not until it wrecked my life.

Okay, I think I'm done ranting now. Here's another picture of the beautiful, scantily clad young woman to make up for my rambling.

She's 21.

That means I'm old enough to be her disapproving father.

Two Weeks

Today makes it two weeks since anyone's read this blog. It wasn't exactly breaking any records to begin with, but the analytics say there've been zero views since my 20 November 2022 post.

Someone nudge me if you're still interested in what I have to say about diabetes. Until then, I'll keep to myself and randomly check in to see if anyone even glances at my last two posts.

When Diabetes Is "the OTHER" Problem

Hey, y'know that disease called diabetes? I certainly HOPE you do. This blog has been all about that silliness. Well, I've mentioned at some point or another that mental illness comes with chronic illness. It's part and parcel for the whole thing. And usually that mental illness is depression. "Why me?" becomes something you ask consciously or unconsciously almost every day. And, boy-howdy, does it suck! What I find most odd is that it's not called "diabetic depression." They tack "diabetic" on as a descriptor for almost every other thing that comes with the illness. Why does depression get left out?

After 48 years of Type 1 diabetes, I practically do everything required to maintain it as though I'm on autopilot. I've set alarms to keep me on that schedule I mentioned last post. When one goes off, I stop what I'm doing, check my glucose, take some insulin, eat a meal, and then go back to whatever it was that I was doing. (Performing these rituals is how I wound up turning "diabetes" into a verb. "Hang on a sec. I have to diabetes.") It's barely an existential speed bump in my day.

But staying on top of my OTHER medications... I wish it was that easy. Get the pills and divvy them up into the three-week pill container I have every third Saturday. This seemingly simple task becomes so arduous in my head. That's my severe recurrent depression in action. And so I fail to get that pill division done, fail to take them regularly, and before I know it those medications have lost their efficacy.

The big one... Well, antidepressants need to be built up to their therapeutic level. It takes four to six weeks for that to happen. What's more, the full dose shouldn't be given at the start. You have to build up to that dose. So it's 10 days at half a tablet to start, 10 days at a full tablet for stage two, and then another 10 days of one and half tablets to reach the full dose.

That said, my pill container only handles three weeks at a time. So I'm still struggling to reach that therapeutic level when it's time to refill it, and... "Oh, why bother? It doesn't matter anyway. No one really cares about me, so why should I work so hard at setting up my pills?" Yeah, that's my depression still holding sway.

I'll let you in on a little secret. I'd say 99% of this entire blog has been written while under the harsh effects of my mental illnesses.

Oh, yeah... Severe recurrent depression isn't my only psych issue. I'm also dealing with PTSD, which is the culmination of several events that either keep me awake all night or make me jump out of my skin while letting loose a scream of terror.

This morning, after taking my 24-hour insulin, (which only works for approximately 20 hours), I looked over at my empty container of other daily meds and... I just wanted to cry. Accompanying the urge to let the tears flow came the fun and exciting thoughts... "I don't care. It's not like missing those meds will cause me to suffer a painful death. Well, maybe my heart meds. I hear heart attacks are pretty painful. But maybe I'll get lucky and have one of those 'instantly fatal' heart attacks. The end. I can stop worrying about... well, everything. No bills. No scheduled medications. No having to put on an act so people think I'm happy and friendly. It can all just end and I can finally get some rest. And who knows? Maybe Heaven, (which I don't believe in), is as depicted in Supernatural. Everyone's Heaven is different. In mine, I'll be fit and healthy... and I'll be younger... and there'll be girls, and movies, and girls, and video games, and girls, and good food, and girls, and visiting D&D nerds to play with, and girls, and comfortable clothes, and girls, and really nice furniture, and girls... Yeah, staying alive is for chumps." 

Looks like nearly five years of being a bachelor is having a bit of an effect on me.

Such thoughts then begin to spiral. What comes next? Approximately 1,000 regrets from my decades of life come to mind. As I dwell on those, the short list of girls I had SERIOUS crushes on in high school pop into my head for a soul-sucking visit. And, hey, while I've got high school on my mind, how about remembering all of the abuse I suffered at the hands of the incubator? Oh, and here's a favorite memory: that job I absolutely LOVED and busted my butt to become an assistant manager, only to be rejected because I didn't suck up to the district manager, and the final result was him not only telling me that I did NOT get the job, but then gave me an absolutely insulting raise of $0.05 per hour for all of my hard work. Makes me wish I'd beaten him with a sack of hammers instead of quietly walking out of his office.

My mind is a playground for the morbidly obsessed.

I don't know if I've mentioned this previously, but I once told my doctor that I'm simply waiting for death. It's not that I'm actively suicidal. I just don't care anymore. And as I wait to shuffle loose this mortal coil, I don't want things to hurt. That's it. Like self-imposed palliative care, I just want to be comfortable while awaiting my demise.

That's why I take such great care of my diabetes. Because NOT taking care of it is a bad way to go. Too much discomfort.

The best part...? The cherry that sits atop this existential sundae made of psychological garbage... is that the complications of my diabetes are constantly reminding me that I could be so much healthier if I'd taken proper care of myself from the start.

Now... Who's in the mood to party?

No one, eh?

Okay. Maybe it's time to end this post. And to lift your spirits, here's a sign that should have mentioned juvenile diabetes instead of... Well...

I say we beat the little rugrats unconscious!

To My Type 2 Diabetics... Again

I'll start with an apology. I'm sorry if you feel left out. When I speak about bending the rules of a diabetic diet, many of you can't do what I suggest. You're probably on oral medications and a far less forgiving diet.

Or are you? 

Okay, let's start with my repetitive reminder: I AM NOT A DOCTOR! I've read a lot of stuff. I've made some reasonable leaps in logic. I have decades of experience as a Type 1 diabetic. So if you read medical advice from me and act on it without consulting your doctor, that's on you.

With that said, maybe you should have a sit-down with your doctor and ask if moving from oral meds to insulin injections would grant you more freedom. Obviously it would best if you simply followed instructions. A large portion of Type 2's are overweight, and the best course of action would be to lose weight. But that's a big ask when you're older and so out of shape that diet and exercise look like an insurmountable task.

Mind you, my first instinct is to tell you to try and lose the weight. No, it's not easy. But if you can afford to buy healthier foodstuffs, then please give it a shot. Because if you succeed, you'll get the natural high that comes with achieving a difficult goal.

If your doctor agrees that switching to insulin would be better for you, you need to understand that you cannot take this change lightly. You're not on the strictest timer in the world, but you better have a scheduled range in place of when to take your insulin regularly. Here. Have another list, this one of the time ranges for my insulin doses.

1. Breakfast: 6:30 - 8:00
2. Lunch: 12:00 - 1:30
3. Dinner: 6:00 - 7:00
4. Bedtime: Wildcard!

"Wildcard." This is my only one that isn't scheduled all that strictly. That's because bedtime could come between 10:00 and 1:00, and there's a sizeable gap between that dose and breakfast. But this is the dose that I'm the most careful with. No cheating with my evening snack. If you read my post about The Somogyi Effect, then you already know this dose is a balancing act. As careful as I am, I still manage to screw it up quite often.

The main point is that you have to take the switch to insulin VERY seriously. A poorly planned meal or dose could see you struggling with glucose readings that swing wildly up and down.

Let's look at two different dates on my glucose records.

The first is the day after I saw my doctor to receive a steroidal injection for, of all things, tennis elbow. How'd I get tennis elbow? No clue. I don't even know where a tennis court might exist where I live. But steroids do goofy things to one's blood sugars, so this is what 12 November 2022 looked like:

1. Breakfast: 273
2. Lunch: 360
3. Dinner: 277
4. Bedtime: 154

That was a rough day. I struggled all day to get my blood sugars in line, and was only partially succeeding toward the end of the day.

Now let's look at a more typical day. This is 22 November 2022.

1. Breakfast: 316 (As mentioned, I still haven't perfected avoiding The Somogyi Effect.)
2. Lunch: 75
3. Dinner: 165
4. Bedtime: 112

Timing. Care. Awareness. These are things that you need to keep in mind when taking insulin.

I have a friend from way back in high school that became a Type 2 diabetic, and he's on insulin now. He tells me how he takes 2 or 3 units per meal, and the tone of my voice switches to that of an adult addressing a child. "Awww, wook who's a big boy, taking his cute wittle insuwin dose." But that small dose is exactly what he needs to keep his glucose levels in line. Does he have it down perfectly? No, but he's trying. I think he said his last Hgb A1c was around 8.0, which isn't good, but far from the worst I've ever heard.

In my educated OPINION, your A1c is going to be your biggest indicator as to whether or not you should be on insulin. If oral meds aren't keeping you between 6.0 and 7.0, then your control might tighten up a lot more with insulin. TALK THIS OVER WITH YOUR DOCTOR!  My "educated opinion" means squat because I don't know your medical history, and I haven't been to med school.

And so we come to the close of yet another blog post filled with what could be excellent advice, or some of the dumbest words to ever come out a guy who thinks he's smart.

I think it's time we brought back the beautiful scantily clad young woman that I used as my shtick in my earliest posts. But this time...

Here she is, scantily clad

at last.

But this is as scantily clad as she ever gets. If you want more of my opinion about her and her "modelling," you'll have to ask. And we all know how that one will play out. 😛

Time for Me Time! (Or You Time.)

Okay, confess. How many of you Googled "kewpie doll" after the last post? C'mon, don't be shy. "I won't point and laugh," he said, pointing and laughing.

This blog about diabetes has been focused on a lot of doom and gloom. You shouldn't do this! Don't do that! You need to worry about the other thing! It really sets a person up for Failure Mentality. That feeling that the goals set in front of you are impossible to reach, so you might as well give up and embrace oblivion.

First, let me revisit the fact that diabetes is a pain in the butt. You have to keep an eye on your blood sugars, take your medication in a timely manner, and see your doctors regularly. There's also a lot of information about the disease that you should keep in mind. If you're young and relatively healthy, you have to think about how something like a lengthy bike ride might affect your blood sugar. If you're older and less mobile, like me, then you're trying to calculate the exact dose of insulin to take with every meal, because changing up our carb consumption is going to be too difficult at this late stage. Without a doubt, it's a mental juggling act.

Unfortunately, you can't ignore those aspects of diabetes. If you do, then feel free to reread all of the aforementioned doom and gloom, and then brace yourself for them to become a reality.

But if you can get a handle on your diabetes and keep your Hgb A1c between 6.0 and 7.0, then you have wiggle room to live a little more freely. Because truth be told, I'm a diabetic with a sweet tooth. And I cheat on my diet DAILY! 

"You want to know what the best junk food is? Ask a diabetic." I have been telling people this for decades. My latest favorite cheat? Cinnamon bears. Soft, chewy, tongue-tingling cinnamon bears. Mmmmmm! I could probably sit to watch a movie and polish off an entire bag.

But I don't. I can't. WE - you and I - CAN'T. That would be a guaranteed visit to the hospital, as well as the extreme discomfort of being sick enough to land there. So how do I do it?

I start with the near-ancient diabetic exchange diet. 15 grams of carbs = 1 piece of bread. I take a fixed number of units of insulin for each "bread" that's in a forthcoming meal. So if a label says there's 46 grams of carbs in the meal, I'm multiplying my dose per carb by three. (I'm not sharing actual numbers because I am EXTREMELY insulin resistant and take A LOT of insulin.)

If you're not seeing how I cheat, then I'm getting a solid gold kewpie doll and dropping it on your foot.

Okay, I'll explain anyway.

My dietary cheating comes with meals, and ONLY with meals. Taking randomly timed doses of insulin throughout the day is a quick way to wind up in a diabetic coma. (Have I even discussed insulin peak times? Let me know.) (See what I did there? I made a funny. Because no one comments. Ha-ha.) Having read the labels of my upcoming meal, I also read the label of what I want to cheat with. Those cinnamon bears of mine are pretty big, so three of them equals 22 grams of carbs. Six bears will be close enough to 44 grams, so I add three more "breads" to my insulin calculations. Now I'm all set for a meal and some dessert.

"But Rob... What if I'm out to eat with friends and want some cake or ice cream after a meal?" 

If you're keeping your A1c between 6.0 and 7.0, then you know your body pretty well. For a small serving, take at least enough insulin to cover one "bread." For larger servings, make it two. Later on, when it's time for that final test of the day, take a dose that covers any potential fallout from your cheating session.

Now that I've taught you all how to cheat on your fairly strict diet, let's get a few things straight.

1. If your Hgb A1c has been 7.1 or higher, don't cheat. Just don't. You need tighter control than that to live more freely. I haven't gone over 7.0 in... Okay, I'm honestly losing track, so let's say seven years. That's why I allow myself to have some fun with my diet.
2. Don't consult your dietician or endocrinologist for permission about this. No one is going to approve of you cheating on what's supposed to be a strict diet. They'll never say, "Sure, play Russian Roulette with gummy bears!" 
3. That said, when you bring your records to the medical professional trying to help you manage your diabetes, if there are upswings in your glucose that are a result of cheating, admit that and explain that that's why your sugar jumped so much. Better they should know than start thinking that you need major adjustments to your care, and they should be impressed with your honesty at the very least.
4. DO NOT, UNDER ANY CIRCUMSTANCES, DO ANY BINGE EATING USING THIS CHEATING METHOD! This is not a free pass to go nuts with all of the things you shouldn't be eating. Diabetes management is still a delicate dance of medication, diet, and exercise. Binge eating is the equivalent of entering a mosh pit. Don't do it!

I think that covers all I have to say on the subject of cheating on a diabetic diet. So now it's time for the glorious ending of my post, where I say or do something silly.

With winter coming in, I'm completely 

with Bernard, Destroyer of Worlds.

We Don't Get Off That Easy

Once you've managed to mismanage your diabetes long enough, everything medical is almost assured to be a lengthy drama. It's the nature of the beast. The main culprit is going to be all of those microvascular structures that have been effectively strangled by sugar.

Have you guessed where I'm going with this? Are you guessing, "infection"? If you are, then you win a kewpie doll! And if you asked yourself, "Is this another dentist thing?", then you'll find a silver nugget inside your kewpie doll!

I'm an absolute stickler for following a doctor's instructions. So when all of those teeth were removed, I avoided solid foods, carbonated drinks, using a straw to drink (like that was something I did regularly), and rinsed with warm salt water post-extractions. 

Here's the thing... Humans are inherently dumb. We do dumb little things regularly. When I'd swallow, my tongue would press against the hard palate of my mouth. Doing so made the point where the front tooth had been removed hurt intensely. So what did I do on the regular without even thinking about it? If you guessed "poked it repeatedly with the tip of your tongue," then the silver nugget inside your kewpie doll will be twice the size of the original.

Because this kind of thing is so "fun," poking it made me cry out in pain every time I did it. Mind you, I wasn't consciously doing it. It was as though my brain needed constant reminders that I still hadn't healed properly. And what's the most feared of all conditions post-tooth-extraction? If you guessed "dry socket," the silver nugget inside your kewpie doll will be replaced with a small gold nugget.

Of course I looked up "dry socket" on Google, looked at a few pictures, and then hopped to the bathroom to take a look. (I have one foot; I don't run anywhere.) Now... What have I said numerous times on this blog? That's right! I'M STILL NOT A DOCTOR! Let's enlarge that gold nugget inside your kewpie doll for getting that one correct, shall we? My immediate assumption was that I had dry socket. The weird part was that it wasn't nearly as agonizing as advertised. Dry socket is supposed to be INCREDIBLY painful at all times. Mine just hurt when poked.

So I called the dental clinic and said that I thought I had dry socket. I offered to avoid coming in if there was a simple solution that could be prescribed at my pharmacy, but the dental assistant I spoke with said dry socket usually occurs within a few days of the extraction and I was calling in the problem 11 days after the fact. I should definitely come in to be assessed.

Remember when I mentioned my previous "emergency" appointment was set three weeks out? Take a guess at how soon they could see me now. Did you guess "same day"? Double the size of the gold nugget in your kewpie doll if you did! Unfortunately, for me to arrange medical transportation, I need 24 hours, so I scheduled for the next day, which was 15 November 2022.

Meanwhile, I was in touch with my PCP about pain management again. Why my PCP and not the dentist? Because it's best to have ONLY ONE DOCTOR managing your pain medications at all times. If you start getting narcotic pain medications from multiple sources, even if it's for documented, legitimate pain, on paper it will look like you're displaying drug-seeking behavior. That's a red flag to other doctors and pharmacies. And in this age of computers, different pharmacies will know if you've received opioids from another dispenser of such medications.

It makes all of the silly conspiracies about tracking chips in vaccines seem incredibly nonsensical. 

The dental visit was short and sweet. The socket was healing just fine, but there was a visible spot of irritation at the tip of my hard palate that indicated I still had lingering infection. Remember that a lot of pus drained from that tooth when it was removed, so residual infection wasn't unexpected. And if you'd forgotten that this post was about infection, I'm afraid I'll have to revoke your kewpie doll.

Without fail, diabetes was part of the wrap-up discussion. "Diabetics are notorious for healing slowly." You might as well get used to hearing that one, since you'll hear it to the end of your days. Cuts, bruises, surgeries... Every medical professional you encounter will assume your recovery will be longer than expected because of diabetes.

So what have we learned, folks?

1. Infection is practically a way of life for diabetics. Seriously, how many times have I brought this up in this blog? Altered microvascular structures limit blood flow to affected areas, making healing exceptionally difficult.
2. Pain management from one source, and ONLY one source. If you're "doctor hopping" in an effort to get painkillers, you need to stop and examine your life, as you may have another serious problem besides diabetes.
3. I have an unnatural desire to stuff precious metals inside kewpie dolls.

And now... Boy, do I have a treat for you! Wait, what?! "A kewpie doll"?!? No one actually gives those out as prizes anymore. No, what I have is a prime example of the kind of hairstyles I grew up with in high school! You're going to love it!

Hair that teased so much that it's pissed!

"Dentist!"

It seemed suitable to give this post the title of one of my favorite songs from Little Shop of Horrors. It's also entirely possible that that very same song is the reason why I fear dentists. Oh, there are plenty of other reasons, but I'm not focused on those. And I'm sure they're out there somewhere, but I personally don't know anyone that's thrilled to go to the dentist, even if all the dentist says, "Looks great. See you in six months."

But those broken teeth of mine needed to be addressed. It was an "emergency" appointment that was set about three weeks from when I called. Nothing quite like a clinic that's overworked and understaffed. And when I initially called, it was the broken tooth to my lower left side that was the issue, causing so much swelling that it could be seen by looking at my cheek! Blessedly, antibiotics cleared that one up.

That's when the broken tooth along the upper front decided to start hurting. And hurting... and hurting... AND HURTING! More antibiotics and MANY more painkillers.

The thing about dental pain is how pervasive it is. It doesn't just hurt at the site of the problem. The pain radiates outward, causing severe pain all over your face and neck. I kept trying not to take 20 mg. of oxycodone every time I started to hurt, even though that would be the final dose in the end. A half-tablet taken every half hour, 5 mg... and 5 mg... and 5 mg... and 5 mg... It was stupid to take it this way. It made tracking when it was safe to take my next dose nearly impossible. Every four hours at the SOONEST! And, stupid me, I'd start the ritual all over again, thinking, This time it'll be different! This time a lower dose will work just fine! Nope.

I saw the dentist on the 3 November 2022. By then I had refined my pain management, taking 10 mg. every half hour and still landing on 20 mg. Because I'm, like, Einstein levels of brilliant. At night, my body was "flirting with a fever." No one would call 99.3 F (37.38 C) a real fever, but it was an indication that something was brewing, especially when my mean temp is lower than 98.6 F/37 C.

So the lovely dental assistant came in, took a couple of x-rays, and - 

Okay, when did x-ray machines become hand-held portable cameras? And does this speak to the speed of technology or to how infrequently I've gone to the dentist? What's more, the pictures were INSTANTLY on the laptop on the counter! I was like a Cro-Magnon man pulled into the future and seeing a wheel for the first time!

The doctor came in, looked at the x-rays, and informed me that the two teeth beside the broken tooth on the side were also beyond saving and preparing to shatter. After a quick chat, it was decided to remove four teeth. The shattered one up front and the three on the side.

LET THE NUMBING BEGIN!

I couldn't feel my left jaw, left side of my tongue, and the left corner of my lips. I also couldn't feel my right nostril, upper gums, and right side of my lips. But the infected tooth still hurt. GODS ABOVE AND BELOW, IT HURT!!! It hurt so much that I was sweating, moaning, and instinctively guarding my mouth with my hands! The doctor tried giving me more anesthetic, and while inserting the needle itself didn't hurt, the moment it got close to where the pain resided is when I cried out.

The doctor couldn't understand it... yet.

Deciding to give the lidocaine a little more time to take effect up front, he went after the side teeth. No problems there. All pressure, no pain. He stitched up the site and moved on to the front tooth.

Post tooth removal, he said that a lot of pus came out. The dental assistant added that when the dentist started applying pressure to get a hold of the tooth fragments, pus was being squeezed out of the sides. In other words, that tooth as SUPER infected! It explained why they couldn't numb it. And it continued to drain afterward. I know because the gauze they gave me to press against the site was decorated red and yellow.

Yes, I agree. EWWWWW!

So why bring this up in a blog about diabetes? To demonstrate that we are like walking, talking Petri dishes when it comes to infection. In rapid succession, I was now on my second round of 875 mg. amoxicillin. Despite this, I had an abscess growing beneath the tooth.

We become complacent when it comes to infection. That's because the most common infection is a break in the skin. You feel it, wash it, and maybe put a band-aid on it if it's still bleeding. But if you leave it uncovered... Well, whaddaya know! It gets infected. Some topical antibiotic and band-aids to cover it, and soon you're on the mend.

But what if you can't treat it topically? Like an abscessed tooth. We've come a long way in terms of medicine, so it has become less frequent, but even a dental infection can kill! Look it up if you don't believe me. Just type "dying from abscessed tooth" and marvel at the results. And common breaks in the skin that go untreated can become septic. Septicemia is when your blood is poisoned by bacteria. Or put it this way: your BLOOD becomes infected!

There is so much to worry about. It can be overwhelming. It can even be terrifying. But my goal isn't to turn you into quivering piles of jelly that hide from the world. My goal is to make you more vigilant. We're at a higher risk for infection, so be on the lookout for it. Be vigilant and you should be fine.

Or, you know, do like me and wait until the last minute to have your crumbling teeth looked at. "A lot of pus drained out when that tooth came out," is really the kind of thing you can bring up at parties and family dinners as a topic of conversation... if you don't want to be invited to future engagements.

Let's end on a laugh. There's a little band called Ninja Sex Party, and they have a perfectly 80's-sounding song called Mansion Party. You should give it a listen, if for no other reason than learning that a panda fighting pit is called a "Pandagon."

Seduction is like a game of Chess

And I'm the queen.

Wait -

NOTE: I chose this song because it's one of the safest NSP songs. No swearing and such. The ones I won't link, but are equally funny to me are: Courtship of the Mermaid (which was my introductory song to them), First Date, I Don't Know What We're Talking About, and Bedtime. Most have "colorful language" that would be unacceptable at work.

You Take One Down and Pass It Around...

It's probably a recurring nightmare for parents... that moment when the kids have learned to count WAY past 10 and start singing One Million Bottles of Beer on the Wall. Especially at the start of LONG a family trip. If you listen hard, you can hear the parents praying, "Please, whatever gods are out there... Kill me, my children, and/or all of us. Just make it stop." The alternative song that brings about prayers for a swift demise is The Song That Never Ends, but it's unrelated to this post.

Time passes, and eventually they/we learn to sing Show Me the Way to Go Home. Oh, but summer camp taught us an even better alternative! Murphy's Saloon, also know as Give a Cheer! 

Give a cheer, give a cheer

For the men who drink the beer

In the cellar of Murphy's Saloon!

They are brave, they are bold

For the whiskey they can hold

In the cellar of Murphy's Saloon!

Well it's drink, drink, drink,

'Till you vomit in the sink!

Yell out your order loud and clear:

MORE BEER!

Well it's more, more, more

'Till you pass out on the floor

In the cellar of Murphy's Saloon!

Apparently, the lyrics are regional, but there's nothing quite like a bus full of teens and tweens singing at the top of their lungs about something they know absolutely NOTHING about!

"Hey, Rob...? This is entertaining and all, but does this have anything to do with diabetes?"

The songs? No. The subject of alcohol? Yes.

There are things about the diabetic diet that can drive a dietician to the brink of madness. Two that I can think of immediately. The first is pizza. Between the variable size of slices, to the mystery of how much sugar might have been used when making the sauce, it makes it next to impossible to calculate carb content. The other thing... well, things, plural... are alcoholic beverages.

Drinks for growed-ups contain the perfect combination of substances to make your body scream, "WHAT'S HAPPENING?!?" If your beverage of choice is beer, it's going to have basic carbs. If you prefer mixed drinks, as I do, then they're going to have sugar. Mind you, I now have only one ounce of booze twice a year - once on my birthday and once on New Year's. But there was a time when I wouldn't turn down a well made Long Island Iced Tea. Gods above and below! You can barely make out the taste of alcohol in one made to perfection. I met one bartender whose secret ingredient was powdered lemonade mix. It was a delicious way to get soused. And the sugar in that lemonade mix probably did horrible things to me that the alcohol politely numbed.

Yeah, the sugar/carbs in various adult beverages drive a diabetic's blood sugar upward. If you're out at a bar, you can't exactly ask the bartender to slap a label of the nutritional value of your drink of choice, so you can't really guess at what dose of insulin you should take to cover your night out.

Besides, alcohol lowers the blood sugar.

Yup. The capricious Fates have decided that having a few drinks with your friends raises and lowers your blood sugar simultaneously. Fun, right?

My years of experience have taught me that it's usually the sugar that wins the glucose tug-of-war, but my best advice...? Don't drink. I don't mean "Don't drink EVER!" Save it for special occasions, just as you would a massive slab of seven layer German chocolate cake. 

Twice a year, I settle down with a single ounce of Irish Mist on the rocks, and I sip it so slowly that the melted ice usually winds up dominating the glass. I rarely finish drinking it. When I was younger, however, I could knock back my drinks like I was on a mission to kill myself that very night. Peach or peppermint schnapps made me the go-to guy at several parties. "Oh, you wanna get smashed faster? Go ask Rob for some of his stash." There was one night when my friends and I bought a bottle of Mescal simply because Van Halen sang about it in their song Cabo Wabo. I wish digital cameras were a thing back then! "We drink Mescal right from the bottle... A salt-shake, a little lick of lime... Mmmm!" They sang it, we did it, and the faces we made as we swallowed what must surely have been gasoline would have made for some interesting tales later in life.

Here it is, later in life, and I can't help but wonder what kind of damage I did during that relatively short period of partying, my blood glucose bouncing up and down from moment to moment. Mind you, I wasn't an alcoholic. Booze was rarely a part of our regular gatherings... which was good, because I wasn't a happy drunk. Some people get happy or violent. I got depressed. It's why I can't even recall the last time I was drunk.

What my friends and I DID do regularly... is a topic for a different day. 

That brings this bit of suggested diabetes management to a close. As with everything else I discuss, what I have to say is a matter of "should" versus "shouldn't." I won't say "you can't" because, as it turns out, I have no way of stopping you from doing anything. And if you doubt what I'm saying or are experiencing outright denial, you can always consult your doctor.

And now, in case any of you are cat lovers...

😉

Yet Another "Happy" Anniversary

Hey. How are ya? You good? Good, good. Glad to hear it.

Me? No, not good at all, really. Y'see, today makes it four years since my left foot was amputated. So, yeah. Not a great day.

I've already told the tale. How my growing concerns post-op on my left foot were dismissed, only to discover a fissure had opened up on the sole of my foot. But in a way, I was lucky. I had just over a year to grow accustomed to the idea that I'd lose the foot. A lot of other people have that kind of thing come as a surprise. I have an ex who was told she had to lose her leg, and that she didn't have much time to decide. The osteogenic sarcoma (cancer) in her knee was VERY aggressive. In fact, in the short time she thought about it and finally agreed, the cancer had moved another inch and a half up her thigh. They ended up taking 90% of her left leg.

Facebook brings up the memories from that time of my life, and I was a psychological mess. 

20 Oct 18: The tears are starting to come much easier now. I was never going to lose a foot because such things would never happen to ME. Amputation was for OTHER diabetics. And while I've had quite a few scares, it was always a bullet I'd successfully dodged. Not this time. Last night, while simply sitting here, I could "feel" the foot gone. Not post-op pain, as that seemed to be beyond the realm of my imagination. I was simply imagining my foreleg coming to a sudden stop mid-way.

Two days later...

22 Oct 18: My nurse after getting a blood pressure of 112 over 68: "You are Spicoli levels of chill."

I don't know. Maybe it was an acceptance of my fate. Maybe it was only a brief calm amidst the storm of emotions I was experiencing. I knew my life was about to change radically, I just didn't know exactly how.

Well, I found out. Tasks that were so simple became tests of balance and endurance. In the hopes that my friends would understand, I would give them a simple challenge: make a sandwich from start to finish on only one foot. That is, from the moment they entered the kitchen to the moment they sat down to eat the sandwich, do it without their raised foot EVER touching the floor. If the raised foot touched the floor, it counted as a hard fall. No one ever reported back if they'd tried it. Maybe they only imagined it and thought that was enough.

Because I lived through that challenge for six solid months, it's no wonder I was so excited to be able to do dishes when I got home with my first prosthetic. Seriously, when I got home, I dropped off all of my prosthetic supplies in my room, and then immediately went to the kitchen to do the dishes. 

The exciting life of an amputee.

And then there was THIS annoyance:

A pic I took the day after I got home

from surgery.

This seemingly innocuous picture is of me trying to cross my legs. Four years later, I still can't adjust to the idea that crossing my legs shin-to-calf is an impossibility unless I'm wearing my prosthetic.

I'm sorry there isn't any humor in this post. I usually try to crack wise at least once, but this one's just too hard. Maybe next time.

A Word of Warning

Most of my last few posts have been about me. Disappointing, isn't it? But then I can't write about you, since... Well, I'm not you.

I know. I'm brilliant like that.

There's an underlying cautionary tale in these posts about me dealing with one crisis after another. If you don't control your diabetes, you could be living a very similar lifestyle. This is different from me telling you about one specific problem in a post. This is the various complications attacking simultaneously. It's a diabetic blister that's followed by your dry, delicate skin tearing when you remove the wound dressing. While your coping with those wounds, even more appear because you unknowingly collide with a whole host of things with your lower legs. The reason you don't know it is because diabetic neuropathy has wrecked your nervous system. 

But why stop with a few open wounds on your lower legs when you can add a dental infection. It wasn't anything so dramatic at first. Just a bit of receding gums from constantly battling dehydration during hyperglycemia, and then the tiniest particle of food gets caught between one of your teeth and your gums. You somehow didn't feel it, and despite brushing your teeth regularly, you ended up with a little invader that thrives in the bacteria-rich environment of your mouth.

Now that you have several trouble spots that can become serious infections, your body goes bananas in its effort to fight. Reserves of sugar and naturally occurring steroids send your glucose skyrocketing, making it even harder to control.

And then, sneaking in under your radar, is something you're completely unaware of. All you did was take some ibuprofen to deal with the pain in your gums. Ibuprofen is an NSAID - Non-Steroidal Anti-Inflammatory Drug. Since your gums were swollen, taking an NSAID seemed like a smart thing to do. Heck, your doctor approved its use!

"So what, Rob? Ibuprofen - AKA Motrin - is an over-the-counter drug. It's no big deal, right?"

Under most circumstances, I'd agree immediately. But there's this little complication for diabetes known as Diabetic Nephropathy - AKA Diabetic Kidney Disease. Like just about every other complication, it boils down to high blood sugars altering the shape and functionality of microvascular vessels. 

Forgive my lack of proper structure, but I'm switching from what could happen to you to what's currently happening to me.

I've been lucky. Only once did I start showing signs of kidney failure in my lab work. But the next time I was tested for it, whatever damage that was supposedly happening was no longer apparent. So precautionary measures were taken. I was put on a very low dose of a drug commonly used to control blood pressure and protect against kidney damage.

Amidst my battle with gingivitis, I was a bit too distracted by the pain to really pay attention to it... but as the pain lessened, I noticed that my right leg was swollen. VERY swollen. Obviously it's water retention, but it's EXTREMELY sudden.

At this stage, while waiting for my PCP to get back to me, I'm going to make an educated guess. I could be completely wrong. Heck, I hope I am! But I could also be right, and that scares me silly.

Brace yourself. It's time for another list.

1. I can't take doses of ibuprofen higher than 400 mg. (Maximum strength is 800 mg.) Exceeding 400 mg. per dose makes my kidneys ache. Why? Because...
2. Ibuprofen can cause nephrotoxicity - poisoning of the kidneys. This isn't to say that this is a common risk, but people with existing kidney disease and heart disease should definitely consult their doctor.
3. About a year ago, a lab test came back with a cautionary flag. There was a trace of hematuria - blood in the urine not visible to the naked eye. This is NOT what they look for when testing for diabetic nephropathy, but in my semi-panicked brain, it could be a sign something was off. (They typically look for albumin, a blood protein your kidneys should not be filtering out.)
4. During my gingivitis adventure, I was taking 400 mg. of ibuprofen every eight hours. Regardless of the dose size, it would be taken every eight hours at the most. This, however, was more ibuprofen than I'd taken in a LONG time.

So, ummm... Did I damage my kidneys with an OTC during a completely different crisis?

Okay, let's all stop and take a deep breath. It's important to remember that I'M STILL NOT A DOCTOR! I'm fully capable of making myself paranoid, especially when "doing my own research on the internet." In fact, I'm sure if I dug deep enough, I could have myself diagnosed with "leg cancer" by the end of the day. This is why I'm constantly telling you to consult your doctor. I can only offer up so much information before I reach the limit of my knowledge.

As is my habit, it's time to add pictures to my post. I'm afraid I don't have a beautiful woman or silly joke this time around. No, what I have are a couple of pictures of the swelling in my leg.

Oy vey 1.

Oy Vey 2.

Maybe you can see it, maybe you can't. My leg is significantly larger until it reaches the discolored portion, where the swelling suddenly stops. And in the second picture, you get to see the scab of yet another leg wound.

The good news...? The site of the diabetic blister has healed up nicely, hasn't it?

Okay, readers. I'm off to stew in my paranoia and await word from my PCP. I'm more than likely going to need a lab workup to determine what's ACTUALLY happening. I'm also going to mourn my carb-free snacks, as the reason I was able to get away with them was my lack of water retention. "Alas, poor Pork Rinds. I knew them, Horatio. A snack of infinite yumminess." 🙁

EDIT: My PCP has gotten back to me. He agreed that NSAIDs can cause kidney troubles, and told me to stop using the ibuprofen, (which I already did), and cut down my salt content, (which I already did). If I don't see improvement soon, he'll order labs. Personally, I'd prefer he order them now, but as stated earlier, I'm not a doctor.

Please Kill Me

Hey, I'm asking nicely. That's gotta count for something.

The thing is, I'm writing under duress. I am NOT well. I believe I've mentioned diabetic gum disease previously, which is plain old gum disease put in a shiny "diabetic" wrapper. Well, I have a doozy of an infection going on right now.

It started, much to my dismay, when one of my molars snapped off at the gum-line. How any tooth decay was occurring without me feeling exceptional pain is a mystery. But the tooth cracked apart, leaving just the roots behind.

No problem. I wasn't in pain. Life would go on.

Until it didn't. It takes a special level of stubbornness to be aware of how much risk diabetes puts me at, and then willfully ignore it for even a minute. But that's what I did, allowing something to get into the disaster area where a tooth once resided. It could have been the tiniest particle of food. I don't know. But I soon found myself writing to my doctor via the patient portal to ask for antibiotics for a gum infection.

This infection, however, is on steroids or something. The pain kept increasing and the area started swelling. That popular pain scale of 1 to 10 had me reporting to my doctor that I was experiencing a 10. I couldn't concentrate on anything. I was falling asleep only when I was completely exhausted. And the local dental clinic...

The local dental clinic is understaffed and overwhelmed. I have been calling them early in the day to try and get one of their daily emergency slots, but because the entire town is calling at the same time, I could never get through. When I finally DID get through, they set up an emergency appointment for me... at the start of November.

Because I needed immediate help, I went to my PCP. My hope was that he'd numb me up with lidocaine. My hopes were dashed, but replaced with something better. Toradol! This is an anti-inflammatory that can be given intravenously or intramuscularly. (In a vein or in a muscle, respectively.) Within 15 minutes, all of my major aches were put on hold as it took effect. 

Not every excellent painkiller is an opioid. 😉

He also gave me a shot of penicillin. Medications that are injected tend to be more effective than those taken orally. To go with the shot, he ordered up a stronger oral antibiotic at my pharmacy.

My discussion with the doctor included some warnings. If the pain didn't get better. If it became more intense. If the swelling increased. If I started running a fever. If I lost complete control of my blood sugars. If any or all of these ifs came to fruition, go to the emergency room. Because they could indicate the infection is settling into deeper soft tissues.

All of that was on Thursday afternoon.

Here we are on Saturday, and - PLEASE, FOR THE LOVE OF ALL THE GODS, KILL ME! ~ ahem ~ That is, things are a bit different. The swelling has gone down and the pain has... diffused. I can actually poke at the trouble spot and feel very little pain, but much of the left side of my face aches. A LOT! I feel feverish, but I've checked my temp three times today and I haven't cracked 98.4 F. (36.8 C for any of you Metricans out there.) Overall, I feel mostly terrible.

Now comes the silly, stupid debate in my head. Reasons why I SHOULDN'T call an ambulance:

1. It's less than 48 hours since I received that penicillin shot, and just over 24 hours since I started the stronger oral meds. I should give them more time.
2. Not knowing if they'd admit me, I should probably pack a bag... but I desperately need to do laundry. Right now, I have nothing to pack.
3. There's the possibility that I'm not actually sick enough. I'd hate to go to the ER and waste their time.
4. I would have to call an ambulance to get to the hospital, and I simply don't feel like my current ailment is a valid use of their time. There are heart attack victims and people getting into car accidents. They need an ambulance more than I do.

Okay. Reasons why I SHOULD call an ambulance:

1. I feel super-mega-icky!

Foolishly, I'm going to hold out another day or two to see if I improve. If the pain intensifies or I finally DO crack a fever, which most hospitals define as 100.5 F (38.05 C), I won't hesitate to call for help. But right now, I feel like this illness isn't well-defined enough to warrant emergency care.

"Rob, this is all terrible for you, but... ummm... this is supposed to be your blog about diabetes, remember?"

Trust me, I haven't forgotten. I DID start off talking about diabetic gum disease, and you may have missed it, but one of the reasons I should get to the hospital is if I can't control my blood sugars. That's because infections can do a number on glucose control. Your body will throw glucose reserves into your bloodstream to provide enough energy to fight the infection. Poor glucose control is a perfectly valid reason to seek medical help, especially when you're more accustomed to having good control.

That's what I got for today, loyal reader... Assuming any of you are, in fact, loyal. As I depart, I leave you with the most appropriate paint job on a Ford Pinto ever:

If you know, you know. 🤣

Recognizing My Dumb Mistake

It's not easy to look at your own reflection and say, "You knew better, but you did the dumb thing anyway. Are you going to own it? Or are you going to deflect?" And lemme tell ya, I wanna deflect. "No, I didn't do anything wrong. It was the capricious nature of Fate that made my life so difficult." I could then go on to deny any knowledge of what was happening, blame things on my goofy metabolism, and continue blissfully onward... all the while knowing deep down that I was screwing up.

Wow, that was a good opening. I'm gonna end the post there. I don't want to ruin it with words that might upset me.

Well, obviously I can't just end the post. I used a lot of words, but didn't actually SAY anything.

So here's the scenario: Late in the evening, feeling like I've been a good diabetic all day, I decide to treat myself to things that aren't approved for a diabetic diet. Sometimes it's garbage that is better left to the diets of children. Sometimes it's a serving portion that's slightly excessive. (I'm weird, and a larger bowl of Wheatena before bed appeals to me for some reason.) Because I sometimes play guessing games with the math, I take a dose of insulin that I THINK is going to cover me. And when I wake up in the morning, my fasting blood sugar is abnormally high.

Here. These are my fasting blood sugars for the mornings of September 16, 17, and 18 respectively: 248, 342, 400. (It's so weird to get a number as neat as 400, even if 400 is so bad for me.)

After my realization of what was happening and working things out, these are my fasting blood sugars for the mornings of September 22, 23, and 24: 140, 97, 86.

So where was I going wrong? The easy answer is that I was eating too much before bed. But the evidence against that idea is that I'd stopped that practice altogether on the night of the 18th, and my fasting sugars for September 19, 20, and 21 looked like this: 302, 257, 224. That's because, out of habit, I was still taking just a little extra insulin with my evening snack.

Did you catch that? My morning blood sugars were high because I was taking too much insulin!

"But Rob, that makes no sense. If you're taking too much, your morning blood sugars should be REALLY low!" 

You'd be correct, if not for what is known as the Somogyi Effect. The simplest explanation is that while the diabetic is asleep, they become mildly hypoglycemic. As a result, the body releases glucagon to bring the glucose levels back up. The diabetic never feels a thing until they wake in the morning with all of the ugliness that is hyperglycemia.

How did I fix it? (It's list time!)

1. Stop eating random amounts of carbs before bed. Whether it's three or four "breads" on the diabetic exchange diet, I keep it as exact as possible. That means nothing that requires guesswork, like random amounts of hot cereal or leftover pizza.
2. Calculate my insulin dose exactly. No random additions of "just a few more units to make sure I cover X amount of carbs." Account for what my glucose is at the time of the meal, as well as the carbs I'm about to ingest, and NO MORE THAN THAT!
3. Adhere to these steps religiously. It's a pain in the tuchas. It means relinquishing some of the freedom I've felt since taking a proactive stance on my diabetes maintenance. But if I'm not awake to make adjustments on the fly, I'm putting my overall health at risk. And that means...
4. If I'm going to be a bad diabetic, be bad during the day, when I can feel most of the effects of my glucose rising and falling. Well, mostly rising. Falling, as mentioned in my 20 September post, is becoming more and more of an issue.

Of course, suddenly realizing I've been dumb and waking with good fasting glucose levels left room for me to be silly, which is why I was able to post to Facebook on the 23rd...

I wouldn't throw it away! That stuff is worth

more than gold!

Besides, if I told you how much insulin I took to get that 86 for lunch, you'd think I was attempting suicide by insulin. But that's a topic for a different day.

EDIT: Funnily enough, this post is coming after I've written about the absurd amount of insulin I take for a cup of coffee. I originally wrote this post on 24 September, but then got distracted by other things. My apologies.

And as I end this blog, and this is completely unrelated to diabetes, but...

This is gh0xttherebel.

He's been reacting to my favorite American anime, RWBY. His reactions have been absolutely incredible, and his editing skills are off the charts. gh0xttherebel is the channel's name, so if you want a laugh while watching an excellent show, go check him out.

For Want of a Cup of Coffee

I know what you're thinking. "Rob, you absolute paragon of diabetes control. You're like a divine presence come down from the Heavens to lift us up with your stylistic ramblings and fill our heads with important information about diabetes." Yup. Guaranteed, that's what you're thinking, word-for-word. 😉

Okay, so I'm not exactly a psychic. But I have the distinct feeling that some of the people reading this blog might think that I think I'm the patron saint of diabetics. 

Not even close. I'm a good diabetic most of the time. But some of my choices fall under the category of "Do as I say, not as I do."

My last post was about my diagnosis of cardiovascular disease. If you don't know, such a diagnosis comes with even more dietary changes. Reduced fat. Reduced salt. No caffeine. They might as well have told me I'm only permitted to drink water and eat nothing but cardboard. What's funny is that these restrictions are already built into a diabetic diet in hospitals. I found that out when I had to stay the night after the angiogram. They sent me a meal that was labeled "heart healthy," but with packets of sugar and a fruit cup loaded with fructose. So I called down to let them know that my meals should also be for a diabetic, and that's when I was told the diabetic menu was even more restrictive than the heart healthy one.

Reduced fat, reduced salt, no caffeine, and NO SUGAR! 

Now it's the water and cardboard diet, for sure.

During a follow-up appointment with my cardiologist, I credited him with bringing my blood sugars under tighter control. He initially rejected this idea until I explained that with my cardiovascular system no longer struggling as hard to function, the overall stress on my body has been reduced. Similar to the "fight or flight" reflex, my body was in near-perpetual "fight mode" just to function before the stent was placed. That meant naturally occurring steroids were constantly being released into my bloodstream, and steroids make a diabetic's glucose level go up, UP, UP! So once I'd shared my hypothesis with him, he agreed that he might very well be responsible for my blood sugars improving.

Mind you, it was a marginal improvement, but an improvement nonetheless.

For the record, I tried. I did. I bought decaffeinated coffee to get my day started. I'm not affected by caffeine for some bizarre reason. In terms of alertness, that is. If anything, I typically experience caffeine crashes after drinking a cup of coffee. After years of drinking regular coffee, decaf tasted... off. Only one brand ever got it right, and I can't find it for the life of me anymore. 

~ shakes fist impotently at the sky ~ Damn you, Maxwell House!

So I, ummm... I gave up. I have my ONE cup of java in the morning, and that's it. Just one. And one, is seems, is about all I can handle at this point. Because when I drink my singular cup of joe, things inside my aging body go absolutely goofy. 

Let me be clear. The only carbohydrates in my coffee come from my sugar free, French vanilla creamer. Somewhere between 8 to 10 grams of carbs total, which on a diabetic exchange diet isn't even the equivalent of one piece of bread. (15 grams = one bread.) The artificial sweetener I use adds zero carbs. 

I believe I've discussed it before, but I'll review how I decide how much insulin to take. I check to see what my glucose IS, calculate how many "breads" I'll be having with the coming meal, and then add enough for what I assume my glucose WILL BE. Because I'm insulin resistant, my doses are high. VERY high. In fact, when I tell hospital staff how much insulin I would normally take, they silently assume I'm trying to get them to kill me and go with their preset standards. They come in and tell me they're going to give me a "very high dose of 11 units," and I'll reply, "Oh, that is adorable." Later, when my blood sugar is checked and it comes back at 400 or more, they start taking me seriously. If my blood sugar is normal, between 80 and 110, I'll take 28 units of Humalog if there are three "breads" in my coming meal.

But in the morning, if my glucose is normal, (which is rare*), and I'm going to have my coffee, and ONLY my coffee - no other food of any kind - I take... Brace yourselves... 

...

...

...

...

...

48 UNITS OF HUMALOG!

That's probably enough to kill a bear, if not an elephant. This is because the coffee puts a lot of stress on my cardiovascular system. Has this been confirmed medically? Nope. But I'm not eating anything else in the morning, my creamer is sugar free, (but still has carbs, which are accounted for), and I use artificial sweetener. So if someone else can come up with a better theory, I'm all ears. The closest thing to "proof" are my sparkling lunch readings, which DO come closer to that perfect range.

*About my fasting blood sugars rarely being normal... This is a whole different issue about balancing my insulin doses more carefully at night, which I'll try to get into in the near future.

I'm 55. I have no family. My friends are all distant. I'm both alone and lonely. So I'm going to break some of the rules every now and again, especially if breaking them means I get a little enjoyment out of life.

The proper summoning configuration

to get me out of bed in the morning.